Until I fell ill in February, it had been decades since I'd been in "patient" mode. Now, I have something of a complicated health picture and am dealing with the medical profession on my own behalf constantly.

What's changed over the years? Why do I, who used to work in Medicine in New York, find it such alien(ating) terrain?

There are those who say my native New York doctors and facilities are notoriously more professional and proficient than those here in California. Others say the whole profession has morphed into one in which patients must, much more than ever, concertedly advocate on their own behalves, doctors being less likely to automatically consider themselves accountable to actual patients, due to all the billing/regulatory intermediaries. Radiologists are more likely to rush-read images, and doctors to settle for mere reports without viewing actual films, etc.

I have been struggling with this, having lost the more aggressive insistence that came with the New York territory. I have always counseled the ill, including friends, to clearly assert themselves with medical professionals, and now I find myself in the position to discover how difficult that is to do when ailing. It is far easier said than done, so I'm humbled about it and smell a wildly fertile field in Patient Advocacy/Relations, for those of you seeking new careers.

I spent almost thirty adult years outside Medicine's crosshairs. Needing to avail myself of its services these days, I must mobilize great stores of energy, relearn old skills, learn new systems, and engage new techniques for navigating this terrain, said not-quite-Pollyanna.